A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?
Atrial flutter
Atrial fibrillation
Unstable angina
Premature atrial contractions (PACS)
The Correct Answer is B
A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.
B. Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C. Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D. PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Whole milk contains saturated fats, which can contribute to overall cardiovascular health risks. However, it's not directly linked to causing PACs. While reducing saturated fat intake is generally beneficial for heart health, whole milk alone might not significantly exacerbate PACs compared to other dietary factors.
B. Black tea contains caffeine, which is a stimulant that can potentially increase heart rate and trigger PACs or other irregular heart rhythms in sensitive individuals. Therefore, black tea is a consideration for clients with PACs as it can be a potential trigger.
C. Bacon is high in saturated fat and sodium, which can contribute to cardiovascular risks and overall heart health concerns. High-fat foods like bacon can indirectly influence heart rhythms, but there's not a direct correlation between consuming bacon and PACs.
D. Eggs and cheese are high in saturated fats and cholesterol, which can impact cardiovascular health. While not directly linked to causing PACs, the high-fat content of scrambled eggs with cheese may contribute to overall heart health concerns.
Correct Answer is C
Explanation
A. While assessing pedal pulses is important for circulation and can indicate peripheral vascular status, it is not the highest priority compared to assessing renal function in a client with TTP.
B. Nutritional status is important for overall health and recovery but is not immediately critical compared to assessing for acute complications such as kidney damage in TTP.
C. TTP can lead to kidney damage due to the formation of clots in the small blood vessels of the kidneys. This can result in decreased urine output or even acute kidney injury (AKI). Monitoring urine output is crucial to assess renal function and detect early signs of kidney involvement.
D. TTP primarily affects the kidneys and blood coagulation system, leading to hemolysis and thrombocytopenia. Liver function is not typically a primary concern in TTP unless there are concurrent issues or complications.
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